Cardiology Question for the Week of February 20, 2017

Question:

Can we bill codes 93620 and 93656 (both relate to comprehensive electrophysiologic evaluation) together? Are there any other codes that may be billed with 93656, or is it all encompassing?

Answer:

According to the CPT book, 93620 may not be coded with 93656. When performed, you can code one of the following with 93656, but these two codes cannot be assigned in the same encounter:

93609 Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (List separately in addition to code for primary procedure)
93613 Intracardiac electrophysiologic 3-dimensional mapping (List separately in addition to code for primary procedure)

The following code may be billed with 93656:

93623 Programmed stimulation and pacing after intravenous drug infusion (List separately in addition to code for primary procedure)

If a separate and identifiable non-atrial fibrillation site is ablated, you can report the following code in addition to 93656:

93655 Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (List separately in addition to code for primary procedure)

For additional right or left atrial fibrillation that is separate from the original site ablated, you can report the following:

93657 Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (List separately in addition to code for primary procedure)

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